Treatment of the Arthrit ic Valgus Ankle

The alignment of the hindfoot can be divided into 3 anatomic aspects: supramalleolar, tibiotalar (orientation of the line of the tibiotalar joint), and inframalleolar.1–8 The medial distal tibial angle (MDTA) is used to quantify supramalleolar alignment. In a radio-graphic study9 it measured 92.4 3.1 (range 88–100) and in a cadaver study it measured 93.3 3.2 (range 88–100).10 The mortise view should be used for measurements of the MDTA because it depends on radiographic technique, specifi-cally the length of the tibia visible in the radiograph.11 In general, reliable assessment of the inframalleolar alignment is much more difficult. Visual inspection of the hindfoot and clinical measurements with a goniometer are inaccurate.8,12–14 The mortise view The authors have nothing to disclose